Provider Demographics
NPI:1326016932
Name:TIERI, ROCCO CAMILLO (ATC)
Entity Type:Individual
Prefix:MR
First Name:ROCCO
Middle Name:CAMILLO
Last Name:TIERI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S ELMHURST RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5507
Mailing Address - Country:US
Mailing Address - Phone:847-718-7136
Mailing Address - Fax:
Practice Address - Street 1:900 S ELMHURST RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5507
Practice Address - Country:US
Practice Address - Phone:847-718-7136
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer